Postresuscitation care and prognostication after cardiac arrest-Does sex matter?

Abstract

BACKGROUND:

There are conflicting results concerning sex-specific differences in the post-cardiac arrest period. We investigated the sex distribution of patients after successful cardiopulmonary resuscitation (CPR), differences in treatment, complications, outcome and sex-specific performance of biomarkers for prognostication of neurological outcome.

METHODS:

Prospective observational study including cardiac-arrest (CA) patients treated with mild therapeutic hypothermia (MTH) at 33 °C for 24 h or normothermia. We investigated common complications including pneumonia and acute kidney injury (AKI) and neuron-specific enolase, secretoneurin and tau protein as biomarkers of neurological outcome, which was assessed with the cerebral performance categories score at hospital discharge.

RESULTS:

Out of 134 patients 26% were female. Women were significantly older (73 years, interquartile range (IQR) 56-79 years vs. 62 years, IQR 53-70 years; p = 0.038), whereas men showed a significantly higher rate of pneumonia (29% vs. 6%; p = 0.004) and a trend towards higher rates of AKI (62% vs. 45%; p = 0.091). Frequency of MTH treatment was not significantly different (48% vs. 31%; p = 0.081). Female sex was not associated with neurological outcome in multivariable analysis (p = 0.524). There was no significant interaction of sex with prognostication of neurological outcome at 24, 48 and 72 h after CPR. At the respective time intervals pinteraction for neuron-specific enolase was 0.524, 0.221 and 0.519, for secretoneurin 0.893, 0.573 and 0.545 and for tau protein 0.270, 0.635, and 0.110.

CONCLUSION:

The proportion of female patients was low. Women presented with higher age but had fewer complications during the post-CA period. Female sex was not associated with better neurological outcome. The performance of biomarkers is not affected by sex.

• Authors: Julia Hasslacher, Hanno Ulmer, Georg Lehner, Sebastian Klein, Timo Mayerhoefer, Romuald Bellmann, Michael Joannidis
• Journal: Wiener klinische Wochenschrift (Wien Klin Wochenschr) Vol. 134 Issue 17-18 Pg. 617-625 (Sep 2022) ISSN: 1613-7671 [Electronic] Austria
• PMID: 35380262 (Publication Type: Journal Article, Observational Study)
• Copyright: © 2022. The Author(s).

Chemical References

• Biomarkers
• tau Proteins
• Phosphopyruvate Hydratase

Topics

• Acute Kidney Injury
• Biomarkers
• Cardiopulmonary Resuscitation (adverse effects)
• Female
• Heart Arrest (diagnosis, epidemiology, therapy)
• Humans
• Hypothermia, Induced (methods)
• Male
• Phosphopyruvate Hydratase
• tau Proteins